Can you take Mycophenolate mofetil with Myrac?

The minocycline in Myrac has a moderate potential interaction with Esophageal Obstruction.

The use of oral tetracycline capsules and tablets has been associated with esophageal irritation and ulceration in patients who ingested the drug without sufficient fluid shortly before bedtime. Therapy with solid formulations of tetracyclines should preferably be avoided in patients with esophageal obstruction, compression or dyskinesia. If the drugs are used, patients should be advised not to take the medication just before retiring and to drink fluids liberally.

Mycophenolate mofetil has a moderate potential interaction with Gastrointestinal Hemorrhage.

Gastrointestinal, rectal, and duodenal hemorrhage, hemorrhagic pancreatitis and rarely, large-intestine perforation have occurred in patients receiving mycophenolate. These events occurred primarily at dosages of mycophenolate >2 grams per day. Therapy with mycophenolate should be administered cautiously in patients with active gastrointestinal disease.

Mycophenolate mofetil has a moderate potential interaction with Inflammatory Bowel Disease.

Gastrointestinal, rectal, and duodenal hemorrhage, hemorrhagic pancreatitis and rarely, large-intestine perforation have occurred in patients receiving mycophenolate. These events occurred primarily at dosages of mycophenolate >2 grams per day. Therapy with mycophenolate should be administered cautiously in patients with active gastrointestinal disease.

Mycophenolate mofetil has a moderate potential interaction with Lesch-Nyhan Syndrome.

Mycophenolate mofetil is an inosine monophosphate dehydrogenase (IMPDH) inhibitor; therefore it should be avoided in patients with hereditary deficiencies of hypoxanthine-guanine phosphoribosyl-transferase (HGPRT) such as Lesch-Nyhan and Kelley-Seegmiller syndromes because it may cause an exacerbation of disease symptoms characterized by the overproduction and accumulation of uric acid leading to symptoms associated with gout such as acute arthritis, tophi, nephrolithiasis or urolithiasis and renal disease including renal failure.

Mycophenolate mofetil has a moderate potential interaction with Liver Disease.

Mycophenolate mofetil (inactive) undergoes complete presystemic metabolism to active MPA , further metabolism to inactive forms, some of which undergo enterohepatic circulation producing a second peak of MPA. Alcoholic cirrhosis (parenchymal cell damage) does not appear to affect the metabolism of MPA to inactive forms. Hepatic disease/dysfunction due to other etiologies may induce different effects.

The minocycline in Myrac has a moderate potential interaction with Liver Disease.

The use of tetracyclines has rarely been associated with hepatotoxicity. Histologic fatty changes of the liver, elevated liver enzymes, and jaundice have been reported, primarily in patients treated with large doses of intravenous tetracycline hydrochloride (no longer available in the U.S.) but also in patients receiving high oral doses of these drugs. Therapy with tetracyclines should be administered cautiously in patients with preexisting liver disease or biliary obstruction. Reduced dosages may be appropriate, particularly with minocycline and doxycycline, since the former is metabolized by the liver and the latter undergoes enterohepatic recycling. Liver function tests are recommended prior to and during therapy, and the concomitant use of other potentially hepatotoxic drugs should be avoided.

Mycophenolate mofetil has a major potential interaction with Neutropenia.

Severe neutropenia has occurred in up to 2% of patients administered mycophenolate. Therapy with mycophenolate should be administered cautiously in patients with or predisposed to neutropenia. Mycophenolate should be discontinued or the dose reduced in patients who develop neutropenia (absolute neutrophil count <1300/mm3). Clinical monitoring of hematopoietic function is recommended. Complete blood counts should be performed weekly during the first month, two times a month during the second and third months, and monthly for the remainder of the first year of treatment.

The minocycline in Myrac has a major potential interaction with Noninfectious Colitis.

Clostridioides difficile-associated diarrhea (CDAD), formerly pseudomembranous colitis, has been reported with almost all antibacterial drugs and may range from mild diarrhea to fatal colitis. The most common culprits include clindamycin and lincomycin. Antibacterial therapy alters the normal flora of the colon, leading to overgrowth of C difficile, whose toxins A and B contribute to CDAD development. Morbidity and mortality are increased with hypertoxin-producing strains of C difficile; these infections can be resistant to antimicrobial therapy and may require colectomy. CDAD must be considered in all patients who present with diarrhea after antibacterial use. Since CDAD has been reported to occur more than 2 months after antibacterial use, careful medical history is necessary. Therapy with broad-spectrum antibacterials and other agents with significant antibacterial activity should be administered cautiously in patients with history of gastrointestinal disease, particularly colitis; pseudomembranous colitis (generally characterized by severe, persistent diarrhea and severe abdominal cramps, and sometimes associated with the passage of blood and mucus), if it occurs, may be more severe in these patients and may be associated with flares in underlying disease activity. Antibacterial drugs not directed against C difficile may need to be stopped if CDAD is suspected or confirmed. Appropriate fluid and electrolyte management, protein supplementation, antibacterial treatment of C difficile, and surgical evaluation should be started as clinically indicated.

Mycophenolate mofetil has a moderate potential interaction with Peptic Ulcer.

Gastrointestinal, rectal, and duodenal hemorrhage, hemorrhagic pancreatitis and rarely, large-intestine perforation have occurred in patients receiving mycophenolate. These events occurred primarily at dosages of mycophenolate >2 grams per day. Therapy with mycophenolate should be administered cautiously in patients with active gastrointestinal disease.

Mycophenolate mofetil has a moderate potential interaction with Renal Dysfunction.

Mycophenolate undergoes complete presystemic metabolism to its active form, MPA . Less than 1% of MPA is excreted in the urine. In a single-dose study, the area under the curve (AUC) for MPA in patients with severe chronic renal impairment (creatinine clearance <25 mL/min) was approximately 75% greater than those of healthy volunteers (creatinine clearance >80 mL/min). The AUC for the inactive metabolite was 3 to 6 times higher. Multiple dose studies have not been performed. No data are available for cardiac transplant patients with severe renal impairment and when benefit outweighs risk, therapy with mycophenolate should be administered with extreme caution.

The minocycline in Myrac has a moderate potential interaction with Renal Dysfunction.

Tetracyclines (except doxycycline) are eliminated by the kidney to various extent. Patients with renal impairment may be at greater risk for tetracycline-associated hepatic and/or renal toxicity (increased BUN with consequent azotemia, hyperphosphatemia, and acidosis) due to decreased drug clearance. Therapy with tetracyclines should be administered cautiously at reduced dosages in patients with renal impairment. Clinical monitoring of renal and liver function is recommended, and serum tetracycline levels may be necessary during prolonged therapy.

Mycophenolate mofetil has a moderate potential interaction with Vaccination.

During treatment with mycophenolate mofetil, the use of live attenuated vaccines should be avoided and patients should be advised that vaccinations may be less effective. Advise patients to discuss with the physician before seeking any immunizations.